慢性肺心病患者血浆心钠素浓度变化及其临床意义

应用放免法测定了37例正常人、68例慢性肺心病患者血浆心钠素(ANP)浓度。慢性肺心病心功能代偿期血浆ANP浓度与正常人无差异(P>0.05),而心功能失代偿期则明显低于正常人和心功能代偿期(P值均<0.01)。心功能Ⅳ级时血浆ANP降低最明显,而Ⅲ级又明显低于Ⅱ级。心功能不全纠正后血浆ANP明显上升,但心功能不全未纠正者临终前最低。表明慢性肺心病时血浆ANP浓度的动态变化可作为估计病情、观察疗效和判断预后的一个指标。     

不同心功能状态下心房纤颤患者的血浆心钠素水平

采用放射免疫法测定32例心房纤颤病人和正常人血浆心钠素(ANP)。发现心房纤颤患者的ANP明显低于对照组(P<005);血浆ANP与心功能分级呈负相关(r=-0.570,P<0.05),与心房纤颤病程无关(r=-0.173,P>0.05);不同年龄和病因之间ANP差别无显著性(P>0.05)。提示心房纤颤患者血浆ANP含量取决于心功能状态。     

老年人心血管、脑疾病心钠素测定的临床意义

本文着重介绍了采用作者建立的一种灵敏的放射免疫方法,测定老年心血管、脑疾病中血浆ANP含量。晚期肺心病老年患者,血浆ANP含量明显低于早期PHD者(P<0.05)。伴有左心室肥厚的高血压老年患者血浆ANP浓度明显高于左心室正常的高血压患者(P<0.01)。高血压脑卒中后血压仍高和血压正常的老年患者,血浆ANP分别为861.1±108.4和536.8±50.1pg/ml。总之,测定老年人血浆ANP的浓度,对于探讨老年人心血管、脑血管疾病的发病机理和病情严重程度有重要意义。     

老年冠心病心功能不全患者血浆白细胞介素-6浓度的变化

目的 :观察老年冠心病心功能不全患者血浆白细胞介素 6 (interleukin - 6 ,IL - 6 )浓度的变化。方法 :选择老年冠心病心功能不全患者 48例、心功能正常者 15例及健康老年人 30例 ,采用酶联免疫吸附法测定其血浆IL - 6浓度。结果 :冠心病心功能不全组血浆IL - 6浓度较冠心病心功能正常组及健康对照组明显增高 (均P <0 .0 5 ) ,而冠心病心功能正常组与健康对照组之间无明显差异 (P >0 .0 5 ) ;血浆IL - 6浓度与左室射血分数呈负相关 (r =- 0 .6 0 ,P <0 .0 1) ;因心功能不全恶化再入院患者血浆IL - 6浓度高于未再入院患者 (P <0 .0 1)。结论 :IL - 6具有判断病情、评价预后的价值     

口服避孕药对动脉血压与血浆心钠素水平的影响

观察25例口服避孕药妇女的血压和血浆 ANP 变化,其中血压正常者血浆ANP 无明显变化(P>0.05),血压增高者血浆 ANP 明显增高(P<0.01)。服药者血浆ANP 水平与血压呈高度正相关(P<0.01),与服药时间无关(P>0.05)。提示口服避孕药可能是通过血压增高使血浆 ANP 水平增加,而其引起的血压增高是高 ANP 型的。     

倍他乐克缓释片对心肌梗死后左心功能不全的影响

目的探讨倍他乐克缓释片对心肌梗死后左心功能不全的影响。方法 68例心肌梗死后左心功能不全患者随机分为倍他乐克组和对照组。两组均予以常规内科治疗,倍他乐克组加用倍他乐克缓释片,连用12个月。结果治疗12个月后,两组血浆AngⅡ、ALD及血浆BNP浓度均明显改善(P<0.05或P<0.01),且倍他乐克组改善幅度大于对照组(P<0.05);同时倍他乐克组治疗总有效率明显优于对照组(χ2=4.19,P<0.05)。两组治疗期间药物不良反应发生率比较无统计学差异(χ2=1.44,P>0.05),未发生严重的药物不良反应。结论倍他乐克缓释片治疗心肌梗死后左心功能不全能有效改善患者左心功能,疗效显著,安全性较好。     

脑钠肽在老年慢性心力衰竭诊断及预后评估中的应用价值

目的观察血浆脑钠肽(BNP)水平与老年慢性心力衰竭(CHF)患者心功能分级的关系,探讨BNP在老年CHF早期诊断及预后评估中的临床应用价值。方法选择老年CHF患者183例(CHF组)和健康老年人62例(对照组),比较不同心功能分级老年CHF患者血浆BNP和心肌肌钙蛋白I(cTnI)水平,并分析老年CHF患者血浆BNP水平与左心室射血分数(LVEF)和左心室舒张末期内径(LVEDD)的关系。结果 CHF组心功能Ⅰ级患者血浆BNP水平与对照组比较差异无统计学意义(P>0.05),CHF组心功能Ⅱ、Ⅲ、Ⅳ级患者血浆BNP水平显著高于对照组(P<0.05),心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级患者血浆BNP水平两两比较差异均有统计学意义(P<0.05)。CHF组心功能Ⅰ、Ⅱ级患者cTnI水平与对照组比较差异均无统计学意义(P>0.05),CHF组心功能Ⅲ、Ⅳ级患者cTnI水平显著高于对照组(P<0.05),CHF组心功能Ⅲ、Ⅳ级患者cTnI水平显著高于心功能Ⅰ、Ⅱ级患者(P<0.05),CHF组心功能Ⅳ级患者cTnI水平显著高于心功能Ⅲ级患者(P<0.05),CHF组心功能Ⅰ、Ⅱ级患者cTnI水平比较差异无统计学意义(P>0.05)。CHF患者血浆BNP和cTnI水平与心功能分级均呈显著正相关(P<0.05)。血浆BNP水平与LVEDD呈显著正相关(P<0.05),而与LVEF呈显著负相关(P<0.05)。结论 BNP在老年CHF的诊断及预后评估中有重要的临床价值。     

慢性心功能不全患者血浆内源性洋地黄样因子浓度的临床观察

本文采用地高辛放射免疫测定法检测42例慢性心功能不全患者和31例正常人血浆EDLF浓度,结果显示:慢性心功能不全组血浆EDLF浓度明显高于正常组,而各级心功能不全组之间血浆EDLF浓度无明显差别;右心功能不全组血浆EDLF高于左心功能不全;心功能不全患者血浆EDLF浓度与血清K~+呈明显负相关(r=-0.37,n=35,P<0.025),而与血清Na~+无明显相关。内源性洋地黄样因子Endogenous digitalis-like factor,EDLF)是体内具有洋地黄样作用的生物活性.物质,能抑制钠-钾ATP酶活性,竞争性抑制~3H哇巴因与受体结合,可与地高辛抗体发生交叉免疫反应,有强心、缩血管和利尿作用。为探讨EDLF与心功能不全的关系,我们对42例慢性心功能不全患者和31例正常人采用地高辛放射免疫测定法进行血浆EDLF浓度检测,以分析其意义。     

慢性心力衰竭患者治疗前后心钠素、脑钠素浓度变化

目的 观察慢性心力衰竭患者心钠素、脑钠素浓度改变及卡维地洛对其影响.方法 慢性心力衰竭患者50例(观察组)和正常健康人20例(对照组).采用放射免疫法测定治疗前后血浆ANP、BNP浓度;彩色超声心动图测定左心室射血分数、左心室舒张末期内径等.结果 观察组血浆ANP、BNP浓度均高于对照组(P均＜0.01);临床慢性心力衰竭程度越重,血浆ANP、BNP浓度越高(P均＜0.01);卡维地洛治疗者与常规治疗者治疗满2w后均有血浆ANP、BNP浓度下降,卡维地洛治疗者血浆ANP、BNP浓度下降更明显(P＜0.05);而满3个月时卡维地洛治疗者左心室射血分数、左心室舒张末期内径均比常规治疗者明显改善(P均＜0.05).结论 ANP、BNP浓度可以反映心功能状态;卡维地洛可以降低ANP、BNP浓度及改善心脏重构及心功能.     

心力衰竭时ANP和RAAS的变化与左心功能的关系及卡托普利对其的影响

40例充血性心力衰竭患者,治疗前血浆ANP(心钠素)及RAAS(肾素—血管紧张素—醛固酮系统)水平明显升高,且ANP增高的程度与左心功能呈线性负相关,与心力衰竭的程度呈线性正相关。治疗前ANP浓度与RAAS有明显线性关系,卡托普利及常规治疗后,心功能改善血浆ANP浓度明显下降,说明心力衰竭时血浆ANP浓度可间接反映左心功能水平,并可作为判断治疗效果的间接指标。心力衰竭时ANP浓度升高但不发挥明显利尿利钠作用,其原因可能为其作用被同时增高的RAAS抑制有关。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.